We are now at $12,000+ per capita HC costs in the U.S., 17% of GDP. CMS projects 20% of GDP in only a few years. We are much higher than other counties. The current Commonwealth Fund report of 20 counties is here. All have universal coverage, except U.S. and India.
It appears from the report that the involvement of the national gov’ts is, mostly, funding and standards, not delivery.
Relative to my Fair Tax Proposal, I do think the allocations should be sufficient to cover some level of HC. Some of my thoughts on reforming HC are:
- Universal, mandatory coverage (because I don’t think we have the will to deny those without)
- Phase CMS into a coordinating function working with HC community to
- Set standards of care
- Establish standard HC records
- Encourage centers of excellence and value
- Establish quality measures
- Allow HC provider groups to establish pre-paid care arrangements, reinsuring their excess costs
- Reform tort laws
- Establish last-dollar copays (e.g., plan pays first $x of a procedure, patient pays balance of providers published fee)
- Establish fees for referral management
- Require transparent pricing